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Ninety Percent of Patients Are Satisfied With Their Decision to Undergo Spine Surgery for Degenerative Conditions – Lumbar Spinal Stenosis

The article presents a cross-sectional survey and retrospective review of prospectively collected data to explore how patients perceive their decision to pursue spine surgery for degenerative conditions and evaluate factors correlated with decisional regret. The study found that while 90% of patients overall were satisfied with their decision to undergo spine surgery, 6% regretted the decision, with in-hospital complications and revision fusion significantly associated with higher regret. The medium/high decisional regret group also exhibited worse patient-reported outcome measures at long-term follow-up. The findings suggest that current tools for assessing patient improvement postoperatively may not adequately capture the psychosocial values and patient expectations related to decisional regret in spine surgery for degenerative conditions

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spinal centre in the world

Published article

CONCLUSIONS: Higher decisional regret was encountered in the setting of need for revision fusion, increased in-hospital complications, and worse PROMs. However, 90% of patients overall were satisfied with their decision to undergo spine surgery for degenerative conditions. Current tools for assessing patient improvement postoperatively may not adequately capture the psychosocial values and patient expectations implicated in decisional regret.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Spine (Phila Pa 1976). 2024 Apr 15;49(8):561-568. doi: 10.1097/BRS.0000000000004714. Epub 2023 May 9.ABSTRACTSTUDY DESIGN: Cross-sectional survey and retrospective review of prospectively collected data.OBJECTIVE: To explore how patients perceive their decision to pursue spine surgery for degenerative conditions and evaluate factors correlated with decisional regret.SUMMARY OF BACKGROUND DATA: Prior research shows that one-in-five older adults regret,

Spine (Phila Pa 1976). 2024 Apr 15;49(8):561-568. doi: 10.1097/BRS.0000000000004714. Epub 2023 May 9.

ABSTRACT

STUDY DESIGN: Cross-sectional survey and retrospective review of prospectively collected data.

OBJECTIVE: To explore how patients perceive their decision to pursue spine surgery for degenerative conditions and evaluate factors correlated with decisional regret.

SUMMARY OF BACKGROUND DATA: Prior research shows that one-in-five older adults regret their decision to undergo spinal deformity surgery. However, no studies have investigated decisional regret in patients with degenerative conditions.

METHODS: Patients who underwent cervical or lumbar spine surgery for degenerative conditions (decompression, fusion, or disk replacement) between April 2017 and December 2020 were included. The Ottawa Decisional Regret Questionnaire was implemented to assess prevalence of decisional regret. Questionnaire scores were used to categorize patients into low (<40) or medium/high (≥40) decisional regret cohorts. Patient-reported outcome measures (PROMs) included the Oswestry Disability Index, Patient-reported Outcomes Measurement Information System, Visual Analog Scale (VAS) Back/Leg/Arm, and Neck Disability Index at preoperative, early postoperative (<6 mo), and late postoperative (≥6 mo) timepoints. Differences in demographics, operative variables, and PROMs between low and medium/high decisional regret groups were evaluated.

RESULTS: A total of 295 patients were included (mean follow-up: 18.2 mo). Overall, 92% of patients agreed that having surgery was the right decision, and 90% would make the same decision again. In contrast, 6% of patients regretted the decision to undergo surgery, and 7% noted that surgery caused them harm. In-hospital complications (P=0.02) and revision fusion (P=0.026) were significantly associated with higher regret. The medium/high decisional regret group also exhibited significantly worse PROMs at long-term follow-up for all metrics except VAS-Arm, and worse achievement of minimum clinically important difference for Oswestry Disability Index (P=0.007), Patient-Reported Outcomes Measurement Information System (P<0.0001), and VAS-Leg (P<0.0001).

CONCLUSIONS: Higher decisional regret was encountered in the setting of need for revision fusion, increased in-hospital complications, and worse PROMs. However, 90% of patients overall were satisfied with their decision to undergo spine surgery for degenerative conditions. Current tools for assessing patient improvement postoperatively may not adequately capture the psychosocial values and patient expectations implicated in decisional regret.

PMID:38533908 | DOI:10.1097/BRS.0000000000004714

The London Spine Unit : best recognised spinal centre in the world

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Ninety Percent of Patients Are Satisfied With Their Decision to Undergo Spine Surgery for Degenerative Conditions

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Spine (Phila Pa 1976). 2024 Apr 15;49(8):561-568. doi: 10.1097/BRS.0000000000004714. Epub 2023 May 9.ABSTRACTSTUDY DESIGN: Cross-sectional survey and retrospective review of prospectively collected data.OBJECTIVE: To explore how patients perceive their decision to pursue spine surgery for degenerative conditions and evaluate factors correlated with decisional regret.SUMMARY OF BACKGROUND DATA: Prior research shows that one-in-five older adults regret
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